The recording of drug sensitivities for older people living in care homes
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Care home residents are a frail and vulnerable population who are at a high risk of adverse drug reactions. • The recording of drug sensitivities is important to avoid the inadvertent prescribing, dispensing and administration of an offending drug to a sens...
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| Published in: | British journal of clinical pharmacology Vol. 69; no. 5; pp. 553 - 557 |
|---|---|
| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Oxford, UK
Blackwell Publishing Ltd
01.05.2010
Blackwell Science Inc |
| Subjects: | |
| ISSN: | 0306-5251, 1365-2125, 1365-2125 |
| Online Access: | Get full text |
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| Abstract | WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT
• Care home residents are a frail and vulnerable population who are at a high risk of adverse drug reactions.
• The recording of drug sensitivities is important to avoid the inadvertent prescribing, dispensing and administration of an offending drug to a sensitive resident.
• There have been no studies investigating the recording of drug sensitivities for care home residents.
WHAT THIS STUDY ADDS
• The recording of drug sensitivities for care home residents is suboptimal and there are large discrepancies between records.
• It is concerning that over 90% of sensitivities are not recorded on the care home medicines administration record.
• Systems improvements are required, including the sharing of drug sensitivity status with community pharmacists; this could be achieved by printing sensitivities on prescriptions.
AIMS The aims of this study were to determine the recording of drug sensitivities of elderly care home residents, to describe the nature of sensitivities and to identify and describe discrepancies in the documentation of drug sensitivity status in general practices, pharmacies and care homes.
METHODS A random sample of residents within a purposive sample of care homes (nursing and residential) was selected. A clinical pharmacist inspected the GP medical record, the medicines administration record, and the care home record for each resident to identify drug sensitivities and discrepancies between records and to describe the nature of the recorded sensitivities.
RESULTS The records of 121 residents in 31 care homes were studied. Thirty‐one (26%) residents had at least one documented drug sensitivity in one of the sources inspected, with 48 sensitivities in total recorded. There was no description of the nature of the sensitivities recorded in 39/48 (81%) cases. The number of sensitivities recorded on the medicines administration record, care home record and the GP record were 3 (6%), 29 (60%) and 35 (73%), respectively. Only two sensitivities were simultaneously recorded on all three records.
CONCLUSIONS It was of concern that over 90% of drug sensitivities were not recorded on the medicines administration record which is the final checking document when administering medication. The reason for this was that the dispensing pharmacy was responsible for generating the medicines administration record; however, drug sensitivity status is seldom shared between the GP and the dispensing pharmacy. Printing sensitivities on prescriptions would help to resolve this. |
|---|---|
| AbstractList | The aims of this study were to determine the recording of drug sensitivities of elderly care home residents, to describe the nature of sensitivities and to identify and describe discrepancies in the documentation of drug sensitivity status in general practices, pharmacies and care homes.AIMSThe aims of this study were to determine the recording of drug sensitivities of elderly care home residents, to describe the nature of sensitivities and to identify and describe discrepancies in the documentation of drug sensitivity status in general practices, pharmacies and care homes.A random sample of residents within a purposive sample of care homes (nursing and residential) was selected. A clinical pharmacist inspected the GP medical record, the medicines administration record, and the care home record for each resident to identify drug sensitivities and discrepancies between records and to describe the nature of the recorded sensitivities.METHODSA random sample of residents within a purposive sample of care homes (nursing and residential) was selected. A clinical pharmacist inspected the GP medical record, the medicines administration record, and the care home record for each resident to identify drug sensitivities and discrepancies between records and to describe the nature of the recorded sensitivities.The records of 121 residents in 31 care homes were studied. Thirty-one (26%) residents had at least one documented drug sensitivity in one of the sources inspected, with 48 sensitivities in total recorded. There was no description of the nature of the sensitivities recorded in 39/48 (81%) cases. The number of sensitivities recorded on the medicines administration record, care home record and the GP record were 3 (6%), 29 (60%) and 35 (73%), respectively. Only two sensitivities were simultaneously recorded on all three records.RESULTSThe records of 121 residents in 31 care homes were studied. Thirty-one (26%) residents had at least one documented drug sensitivity in one of the sources inspected, with 48 sensitivities in total recorded. There was no description of the nature of the sensitivities recorded in 39/48 (81%) cases. The number of sensitivities recorded on the medicines administration record, care home record and the GP record were 3 (6%), 29 (60%) and 35 (73%), respectively. Only two sensitivities were simultaneously recorded on all three records.It was of concern that over 90% of drug sensitivities were not recorded on the medicines administration record which is the final checking document when administering medication. The reason for this was that the dispensing pharmacy was responsible for generating the medicines administration record; however, drug sensitivity status is seldom shared between the GP and the dispensing pharmacy. Printing sensitivities on prescriptions would help to resolve this.CONCLUSIONSIt was of concern that over 90% of drug sensitivities were not recorded on the medicines administration record which is the final checking document when administering medication. The reason for this was that the dispensing pharmacy was responsible for generating the medicines administration record; however, drug sensitivity status is seldom shared between the GP and the dispensing pharmacy. Printing sensitivities on prescriptions would help to resolve this. WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Care home residents are a frail and vulnerable population who are at a high risk of adverse drug reactions. • The recording of drug sensitivities is important to avoid the inadvertent prescribing, dispensing and administration of an offending drug to a sensitive resident. • There have been no studies investigating the recording of drug sensitivities for care home residents. WHAT THIS STUDY ADDS • The recording of drug sensitivities for care home residents is suboptimal and there are large discrepancies between records. • It is concerning that over 90% of sensitivities are not recorded on the care home medicines administration record. • Systems improvements are required, including the sharing of drug sensitivity status with community pharmacists; this could be achieved by printing sensitivities on prescriptions. AIMS The aims of this study were to determine the recording of drug sensitivities of elderly care home residents, to describe the nature of sensitivities and to identify and describe discrepancies in the documentation of drug sensitivity status in general practices, pharmacies and care homes. METHODS A random sample of residents within a purposive sample of care homes (nursing and residential) was selected. A clinical pharmacist inspected the GP medical record, the medicines administration record, and the care home record for each resident to identify drug sensitivities and discrepancies between records and to describe the nature of the recorded sensitivities. RESULTS The records of 121 residents in 31 care homes were studied. Thirty‐one (26%) residents had at least one documented drug sensitivity in one of the sources inspected, with 48 sensitivities in total recorded. There was no description of the nature of the sensitivities recorded in 39/48 (81%) cases. The number of sensitivities recorded on the medicines administration record, care home record and the GP record were 3 (6%), 29 (60%) and 35 (73%), respectively. Only two sensitivities were simultaneously recorded on all three records. CONCLUSIONS It was of concern that over 90% of drug sensitivities were not recorded on the medicines administration record which is the final checking document when administering medication. The reason for this was that the dispensing pharmacy was responsible for generating the medicines administration record; however, drug sensitivity status is seldom shared between the GP and the dispensing pharmacy. Printing sensitivities on prescriptions would help to resolve this. The aims of this study were to determine the recording of drug sensitivities of elderly care home residents, to describe the nature of sensitivities and to identify and describe discrepancies in the documentation of drug sensitivity status in general practices, pharmacies and care homes. A random sample of residents within a purposive sample of care homes (nursing and residential) was selected. A clinical pharmacist inspected the GP medical record, the medicines administration record, and the care home record for each resident to identify drug sensitivities and discrepancies between records and to describe the nature of the recorded sensitivities. The records of 121 residents in 31 care homes were studied. Thirty-one (26%) residents had at least one documented drug sensitivity in one of the sources inspected, with 48 sensitivities in total recorded. There was no description of the nature of the sensitivities recorded in 39/48 (81%) cases. The number of sensitivities recorded on the medicines administration record, care home record and the GP record were 3 (6%), 29 (60%) and 35 (73%), respectively. Only two sensitivities were simultaneously recorded on all three records. It was of concern that over 90% of drug sensitivities were not recorded on the medicines administration record which is the final checking document when administering medication. The reason for this was that the dispensing pharmacy was responsible for generating the medicines administration record; however, drug sensitivity status is seldom shared between the GP and the dispensing pharmacy. Printing sensitivities on prescriptions would help to resolve this. WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Care home residents are a frail and vulnerable population who are at a high risk of adverse drug reactions. • The recording of drug sensitivities is important to avoid the inadvertent prescribing, dispensing and administration of an offending drug to a sensitive resident. • There have been no studies investigating the recording of drug sensitivities for care home residents. WHAT THIS STUDY ADDS • The recording of drug sensitivities for care home residents is suboptimal and there are large discrepancies between records. • It is concerning that over 90% of sensitivities are not recorded on the care home medicines administration record. • Systems improvements are required, including the sharing of drug sensitivity status with community pharmacists; this could be achieved by printing sensitivities on prescriptions. AIMS The aims of this study were to determine the recording of drug sensitivities of elderly care home residents, to describe the nature of sensitivities and to identify and describe discrepancies in the documentation of drug sensitivity status in general practices, pharmacies and care homes. METHODS A random sample of residents within a purposive sample of care homes (nursing and residential) was selected. A clinical pharmacist inspected the GP medical record, the medicines administration record, and the care home record for each resident to identify drug sensitivities and discrepancies between records and to describe the nature of the recorded sensitivities. RESULTS The records of 121 residents in 31 care homes were studied. Thirty‐one (26%) residents had at least one documented drug sensitivity in one of the sources inspected, with 48 sensitivities in total recorded. There was no description of the nature of the sensitivities recorded in 39/48 (81%) cases. The number of sensitivities recorded on the medicines administration record, care home record and the GP record were 3 (6%), 29 (60%) and 35 (73%), respectively. Only two sensitivities were simultaneously recorded on all three records. CONCLUSIONS It was of concern that over 90% of drug sensitivities were not recorded on the medicines administration record which is the final checking document when administering medication. The reason for this was that the dispensing pharmacy was responsible for generating the medicines administration record; however, drug sensitivity status is seldom shared between the GP and the dispensing pharmacy. Printing sensitivities on prescriptions would help to resolve this. |
| Author | Zermansky, Arnold G. Alldred, David P. Standage, Claire Barber, Nicholas D. Petty, Duncan R. Raynor, D. K. |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/20573092$$D View this record in MEDLINE/PubMed |
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| References | 1997; 54 2006; 13 2002; 360 2009 2008 2007 2006 2004 2002 2007; 31 51 2007; 15 2009; 18 2009; 17 e_1_2_7_5_2 e_1_2_7_4_2 Cantrill JA (e_1_2_7_8_2) 1997; 54 e_1_2_7_2_2 Lee A (e_1_2_7_3_2) 2006 e_1_2_7_7_2 e_1_2_7_6_2 e_1_2_7_19_2 e_1_2_7_18_2 e_1_2_7_17_2 e_1_2_7_16_2 Husband AK (e_1_2_7_11_2) 2007; 15 e_1_2_7_15_2 e_1_2_7_14_2 e_1_2_7_13_2 e_1_2_7_21_2 e_1_2_7_20_2 Shenfield GM (e_1_2_7_9_2); 51 Tempest A (e_1_2_7_10_2) 2006; 13 Oloyede KO (e_1_2_7_12_2) 2007; 15 11422023 - Br J Clin Pharmacol. 2001 Jun;51(6):623-6 19812095 - Qual Saf Health Care. 2009 Oct;18(5):341-6 9248608 - Am J Health Syst Pharm. 1997 Jul 15;54(14):1627-9 20217951 - Int J Pharm Pract. 2009 Aug;17(4):253-5 12133659 - Lancet. 2002 Jul 20;360(9328):225-6 |
| References_xml | – year: 2009 – volume: 13 start-page: 259 year: 2006 end-page: 60 article-title: Auditing the recording of allergy status in community hospitals publication-title: Hosp Pharm – volume: 54 start-page: 1627 year: 1997 end-page: 9 article-title: Accuracy of drug allergy documentation publication-title: American J health-system pharmacy – year: 2002 – volume: 31 start-page: 329 year: 2007 end-page: 32 article-title: Antipsychotic prescribing patterns in care homes and relationship with dementia publication-title: Psychiatr Bull – year: 2007 – year: 2008 – year: 2006 – year: 2004 – volume: 51 start-page: 623 end-page: 6 article-title: Recording previous adverse drug reactions – a gap in the system publication-title: Br J Clin Pharmacol – volume: 17 start-page: 253 year: 2009 end-page: 5 article-title: Accuracy of drug‐allergy recording in a District General Hospital publication-title: Int J Pharm Pract – volume: 18 start-page: 341 year: 2009 end-page: 6 article-title: Care homes' use of medicines study: prevalence, causes and potential harm of medication errors in care homes for older people publication-title: Qual Saf Health Care – volume: 15 start-page: B82 issue: 2 year: 2007 article-title: Audit of the accuracy and consistency of drug allergy recording publication-title: Int J Pharm Pract – volume: 360 start-page: 225 year: 2002 end-page: 26 article-title: Prevalence of dementia in institutional care publication-title: Lancet – volume: 15 start-page: B73 issue: 2 year: 2007 article-title: An audit of drug allergy documentation in a district general hospital publication-title: Int J Pharm Pract – ident: e_1_2_7_5_2 – ident: e_1_2_7_2_2 – ident: e_1_2_7_7_2 doi: 10.1192/pb.bp.106.012880 – ident: e_1_2_7_16_2 – volume: 15 start-page: B82 issue: 2 year: 2007 ident: e_1_2_7_12_2 article-title: Audit of the accuracy and consistency of drug allergy recording publication-title: Int J Pharm Pract – ident: e_1_2_7_21_2 – volume: 15 start-page: B73 issue: 2 year: 2007 ident: e_1_2_7_11_2 article-title: An audit of drug allergy documentation in a district general hospital publication-title: Int J Pharm Pract – ident: e_1_2_7_14_2 – ident: e_1_2_7_18_2 doi: 10.1136/qshc.2009.034231 – ident: e_1_2_7_19_2 – volume: 13 start-page: 259 year: 2006 ident: e_1_2_7_10_2 article-title: Auditing the recording of allergy status in community hospitals publication-title: Hosp Pharm – volume: 54 start-page: 1627 year: 1997 ident: e_1_2_7_8_2 article-title: Accuracy of drug allergy documentation publication-title: American J health-system pharmacy doi: 10.1093/ajhp/54.14.1627 – ident: e_1_2_7_6_2 doi: 10.1016/S0140-6736(02)09461-8 – ident: e_1_2_7_17_2 – ident: e_1_2_7_13_2 doi: 10.1211/ijpp/17.04.0010 – ident: e_1_2_7_15_2 – ident: e_1_2_7_20_2 – volume-title: Adverse drug reactions year: 2006 ident: e_1_2_7_3_2 – ident: e_1_2_7_4_2 – volume: 51 start-page: 623 ident: e_1_2_7_9_2 article-title: Recording previous adverse drug reactions – a gap in the system publication-title: Br J Clin Pharmacol doi: 10.1111/j.1365-2125.2001.01380.x – reference: 11422023 - Br J Clin Pharmacol. 2001 Jun;51(6):623-6 – reference: 12133659 - Lancet. 2002 Jul 20;360(9328):225-6 – reference: 9248608 - Am J Health Syst Pharm. 1997 Jul 15;54(14):1627-9 – reference: 19812095 - Qual Saf Health Care. 2009 Oct;18(5):341-6 – reference: 20217951 - Int J Pharm Pract. 2009 Aug;17(4):253-5 |
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| Snippet | WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT
• Care home residents are a frail and vulnerable population who are at a high risk of adverse drug reactions.
• The... The aims of this study were to determine the recording of drug sensitivities of elderly care home residents, to describe the nature of sensitivities and to... |
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| SubjectTerms | adverse drug reaction Adverse Drug Reaction Reporting Systems - standards Adverse Drug Reaction Reporting Systems - trends Aged allergy care homes Drug Hypersensitivity - etiology Homes for the Aged Humans Medical Records - standards Nursing Homes Pharmacies - standards Prescription Drugs - therapeutic use Short Report |
| Title | The recording of drug sensitivities for older people living in care homes |
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